Hospital and Health Care Facility

AR 331 ARCHITECTURAL DESIGN 07

RSW PR-01:

HOSPITAL AND HEALTH CARE FACILITIES-PHILIPPINES       Date given: January 25, 2011 Due date: February 1, 2011 Date submitted: February 1, 2011

 

Student:       

PION, REDEN S.  

Instructor: 

Arch. Robert Romero

Introduction • “Health care presents a different problem in every country for the way it is organized is a response to geography, climate, historical development, economic situation and social, cultural and political conditions… • Appreciation of these differences is fundamental to understanding of the situation which prevails in a country.”

D efi n ition on H ealth “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” W.H.O.

 

“Health, as we define it today, is a state of complete physical, psychological, social and spiritual well being.” Islamic worldview

……………………Thus, provides the overview that health is not just the absence of disease in physical sense but encompass the whole wellbeing of the person.

WHAT IS A HOSPITAL A hospital, in the modern sense, is an institution for health  care providing patient treatment by specialized staff and equipment, and  often, but not always providing for longer-term patient stays. Its historical  meaning, until relatively recent times, was "a place of hospitality", for  example the Chelsea Royal Hospital, established in 1681 to house  veteran soldiers. Today, hospitals are usually funded by the public sector, by health  organizations (for profit or non profit), health insurance companies  or charities, including by direct charitable donations. Historically,  however, hospitals were often founded and funded by religious orders or  charitable individuals and leaders. Conversely, modern-day hospitals are  largely staffed by professional physicians, surgeons, and nurses,  whereas in history, this work was usually performed by the founding  religious orders or by volunteers. Today, there are  various Catholic religious orders, such as the Alexians and the Bon  Secours Sisters which still focus on hospital ministry.

The basic form of a hospital is, ideally, based on its functions: a. bed-related inpatient functions b. outpatient-related functions c. diagnostic and treatment functions d. administrative functions e. service functions (food, supply) f.  research and teaching functions 5 Ways Hospital Design Influences Patient Health 1. SENSE OF PLACE 2. PRIVATE ROOMS 3. NATURE + ARTWORK 4. NOISE 5. COLOR

BUILDING ATTRIBUTES 1. Efficiency and Cost-Effectiveness 2. Flexibility and Expandability 3. Therapeutic Environment 4. Cleanliness and Sanitation 5. Accessibility 6. Controlled Circulation 7. Aesthetics 8. Security and Safety 9. Sustainability

What is healthcare? • “Essential health care based on practical, scientifically sound and socially acceptable methods and technologies made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination”

H ealth Pyram id • Healthcare buildings encompass the predefined healthcare strata of PRIMARY, SECONDARY and TERTIARY level of care. Tertiary Secondary Primary

The Levelof Care • Primary care embraces all the general health practices, educational, preventive and curative, that are offered to the population at the point of entry into the System. • Secondary Care comprises the care provided by more specialized services to which people are rendered by the primary care services. • Tertiary Care includes highly specialized services not normally found at secondary level, including super-specialties such plastic surgery, neurosurgery and heart surgery.

Principle of Referralof Patients • The principle of referral of patients from  a lower level of care to a higher level as  a method of sorting them according to  their need for specialist diagnosis or the  nature or the degree or their disabilities is  also universally recognised. • Another is aim to work in both direction  for which the reverse is meant for  convalescence.  

Not more than 1000 beds

Large Large District District Hospital Hospital

500-750 beds

Medium Medium District District Hospital Hospital

300-500 beds

Small Small District District Hospital Hospital

150-300 beds 26-150 beds Health Clinic Health Clinic

With and without Alternative Birthing Centre

Community CommunityHealth HealthClinic Clinic //Rural RuralHealth HealthClinic Clinic

TERTIARY CARE

State/General State/General Hospital Hospital

SECONDARY CARE

Normal referral

Just over 1000 beds

PRIMARY CARE

National National Referral Referral Hospital Hospital

Emergency referral

H ealth care R eferral S ystem

B asic H osp ital Form s an d C on f i g u ration s Emergenc y Entry

Outpatient entry The TheOutpatient OutpatientZone Zone

Diagnostic Diagnostic&& Treatment Treatmentzones zones

Visitors Visitors Visitors Control Control

visitors

Inpatient Inpatientzones zones

Medical Medicaland andNon NonMedical Medical Support Zones Support Zones Supplies and Disposal

Naturally ventilated areas are normally long and thin while fully air conditioned areas are thick and wide

In the tropics

W ard Layout natural ventilation and natural lighting.

Clinic Layout Patient Waiting Area

Linking to Main Entrance or Hospital Street

C/E rooms

C/E rooms

Treatment Room

Stores

Dirty Utility

Staff corridor reception

C/E rooms

 

Natural Day light

C/E rooms

C/E rooms

Clean Utility

Procedure Room

Linking to staff areas

D evelopm ent of H ospital Architecture Abroad • UK, USA, EUROPE,JAPAN, SOUTH AFRICA, BRAZIL…

British Experience

• In the early 50s-60s during the energy crises, the British embarked on several hospital development program starting from – – – –

the Greenwich experience, through the Harness system, the Best Buy Mark I, then Best Buy Mark II, through the varied Nucleus Hospital program including the energy efficient Nucleus Hospital of St. Mary on the Isle of Wright.

– Now ..one off designs through……Private Finance Initiative (PFI)

G reenw ich hospital floor

Interstitial Service floor

PLAN PLAN The construction methods would be revolutionary - all lateral engineering services were to be contained in a 6foot gap between floor and ceiling of each pair of floors so that repairs and maintenance works could be carried out without disturbing ward or department routine. All wards would have natural light but the service departments e.g. x-ray, pathology and operating theatres would be in the centre and artificially lit. The whole hospital was to be ventilated mechanically and none of the windows would open so that the air in the wards would be as ‘pure’ as possible.

U SA Experience • Being on private insurance based healthcare system, architects in the United States had to convince the facility management that good healing design is profitable. • Extensive campaign or crusades on both sides of the Atlantic to market the will of healing environment through provision of good view, music therapy, good interior design, lots of sunlight, fresh air and energy efficiency through passive design strategies are done with many researches being conducted to provide evidence that environment do indeed improves the person health outcomes.

European Experience

• In Europe, apart from access to daylight and fresh air, strategies for passive design include the choice of building materials for healthcare buildings that has rigorous requirements. – The material is specifically specified to be environment friendly e.g.the choice of wall and floor finishes should not be from material that can burn nor emit toxic fumes.

• Building services system should promote the recycle of waste water; retention of natural water before gradual discharge; recycle heat energy of air condition to radiators; use of solar power with photo voltaic, wind energy and others.

The Asian Experience • There have been movement in the Asian scene about going back to tradition and local Asian values when designing hospitals. • The deep rooted wisdoms on the use of Feng Shui (literally means wind, water) by the Chinese and Vaastu Shastra by the Indians had made significance come back in this millennium. • Both values, are basically based on the planning of the environment that deals with orientation and provision of good healthy living.

W orldw ide experience sum m ary More hospital planning layouts are going away from deep planning and massive concept to thinner blocks with courtyards to provide

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opportunity for all habitable rooms or spaces to have a natural daylight and view to the outside;

– More patients’ spaces are accessible to the gardens or sizeable courtyards whether it is on the roof-tops or on the ground floors;

– More external cladding, although of high tech material, provides the shades and light at their openings through provision of retractable blinds or hoods as and when necessary.

• Atriums with gardens and natural daylighting are a common feature. Due to their four seasons and differential natural day-lighting intensity throughout the year, ventilation systems need to be boosted with mechanical means to provide the space with the required thermal comfort level.

H ealthcare Facility • “….means any premises in which one or more members of the public receive healthcare services..”

W h at is G overn m en t H ealth care Facility • …” GHF Means any facility used or intended to be used for the provision of healthcare services established, maintained, operated or provide by the Government but excludes privatized or corporatized Government healthcare facilities;”

Facility P lan n in g N orm s Rural Health Clinic

Community Clinic

For 2,000 to 4,000 population.

Health Centre • • • •

For 15-20,000 population State Hospital at every State Regional Hospital Hospital for every district Network of facilities for sub-specialties

General Guide • Base on the principles of total planning & development, the general guide to planning healthcare facilities are as follows:  Site planning  Minimum area or acreage  Component of healthcare facilities  Support facilities

i)

Site Planning

Healthcare facilities should be provided  complete according to its hierarchy:         a) Hospital-includes general     hospital, district hospital, with   or without specialists.    These are provided at state  and district level. b) Health Clinics are provided            at  local level, and     c) Rural Health Clinic is provided            at the rural areas.  

Site Planning ii) The planning on the type of healthcare  facilities must be according to the region and  the catchment area as shown in the Table A; iii) The location of healthcare facilities should be  suitable and appropriate in terms of its  accessibility, quality of the environment, and  safe for the community;  iv) The healthcare site should be access by the  network of roads and near to the public  transportation system;

Site planning v) The location of a hospital need not  necessarily be in the town centre to  avoid traffic congestion; but accessible vi) The location of hospital is not suitable  at noisy and polluted areas;  vii) The site planning of healthcare  facilities must be in accordance  to the  proposed and development strategy in  the local plan as well as approved by  the state authority.

Layout Plan and D esign i)

The design of healthcare facilities  should be a functional design to serve  as the health centres for all  communities; the building should  reflect friendliness; ii) The design should take note the  function and adjacency of the various  work area or departments  base on  the workflow of patients and medical  procedures so as not to obstruct;